Being able to comprehend conversations and follow verbal instructions are things most of us take for granted. But for those with hearing and speech disorders, these simple tasks can become quite challenging.

Caryn McLellan, AuD

“Children and senior citizens commonly present with hearing disorders,” said Caryn McLellan, AuD, an audiologist with UT Physicians and director of audiology in the Department of Otorhinolaryngology-Head and Neck Surgery at McGovern Medical School at UTHealth. “In both, there are certain signs to look for that could determine if there’s a problem that should be addressed.”

Signs of hearing loss in children

The first clue in children is their behavior, and quite often, this is one of the first signs parents may notice.

“Children may not be responding when called or may not be following instructions. What looks to parents and caregivers like the child is being stubborn or ‘just not listening,’ could be hearing loss,” said McLellan. “The child may hear some sounds, but not everything they need.”

If a child’s attention is focused elsewhere, it may take increased volume or cues for a child with hearing loss to understand or acknowledge what is being said, even if they seem to hear well when they are focused on the conversation and looking at the speaker.

Impaired speech may be another sign to look for, particularly in younger children. Quite simply, children cannot repeat what they cannot hear. So, if they are having difficulty speaking clearly, they may not be hearing clearly in the first place. Similarly, if there are sounds consistently absent from their speech, such as the sound of the letter “s,” they may not be hearing it well.

More obvious signs that children are having difficulty hearing may be that they are turning up the volume on the TV or other media and asking “Huh?” a lot.

“What is important to remember is that the signs can be more subtle than people realize, so it’s important to share any concerns you have with your pediatrician or come directly to a pediatric audiologist for testing,” said McLellan.

Signs of hearing loss in seniors

May is Better Speech and Hearing Month. This month represents a time to raise awareness about communication disorders.

In contrast to children, hearing loss in senior citizens usually progresses over a long period of time. First, they will have difficulty understanding speech clearly. Then, as hearing begins to decline, the person may notice others’ speech is audible, but not clear. The person may complain that everyone is mumbling around them and request that others repeat themselves multiple times or to speak louder. Others will not admit they did not understand what was said and instead nod along with the conversation until they can follow it again. They may seem to frequently misunderstand what is being said or give a response that does not fit the conversation.

“Hearing loss can be isolating because some have such a difficult time understanding speech that they withdraw from or avoid difficult listening environments like social gatherings altogether,” said McLellan.

Signs of hearing loss in older adults can look similar to memory loss, depression, or dementia. So, McLellan recommends having hearing tested regularly and addressing any identified hearing loss early for the best outcomes.

Hearing tests

If you detect a hearing problem in children or older adults, the first step is to schedule a hearing test. There is a wide variety of testing methods available depending upon the age and developmental stage of the patient. In infants, responses are recorded as they sleep. These methods may include recording responses from a patient’s ears or using electrodes on the skin to record responses to sound generated from the patient’s brainstem. For older babies and young children, games may be used to demonstrate what sounds they hear. For adults and older children, they might sit in a sound booth and push a button when they hear a beep or repeat words they hear in different levels of background noise.

Hearing aids

An effective and affordable solution for hearing issues is a hearing aid. Much more accepted than they were decades ago, these devices are becoming increasingly smaller, easier to use, and more functional, and they provide clearer sound quality. Some hearing aids can now use Bluetooth technology to connect to cell phones. Connected to phone apps, they allow more direct control over the sound and perform better in background noise than ever before.

“Hearing aids can be an investment, but studies show they are important for overall health, relationships, and quality of life,” said McLellan. “Hearing aids can be effective and discreet, so they are a good option for treating hearing loss that will not respond to medical management.”

More than just hearing

Hearing loss in children can affect their behavior, speech production, academic performance, ability to build and maintain relationships, and self-esteem. In adults, hearing loss typically will continue to progress throughout the lifespan, making communication increasingly difficult. Current research has linked untreated hearing loss with higher rates of dementia, Alzheimer’s disease, fall risk, and depression, among other health concerns.

“Hearing is important, so we encourage everyone to protect themselves from loud sounds and have their hearing tested regularly,” said McLellan.